Mens Health Blog. Medical Blog

Pain is often associated with melancholia and depressive illness. There are two main types of psychological depression. In one type the depression results from a reaction to the loss of some loved one or to worry about some misfortune or wrongdoing. The other type of depression is not caused by any loss, misfortune, or wrongdoing, but comes on from some internal force acting upon us. But with severe depression there is a tendency to blame one’s self. In this state of mind it is easy for psychological pain to develop. The patient feels depressed, he keeps thinking that he has done something wrong, and that he should be punished. He feels that pain is his just desert.

It is important to remember that if your pain is associated with mental depression that shows itself in a tendency to be tearful or just a difficulty in getting started at everyday tasks, then you should see your doctor. If the pain is in fact due to depression it is often effectively relieved by taking one of the new anti-depressant drugs.

We must be clear in our mind about the relationship of pain to depression. Sometimes depressive illness becomes the cause of chronic pain, at other times pain from some other cause brings about nervous depression.

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Q. At long last, let’s get on to the standby therapy of the past fifty years or more — antacids. What is their current status in ulcer treatment?

A. I’m glad you mentioned them, for the current reaction to them is a mixed one. For many years they have been the sheet anchor of therapy, but mainly by default rather than because of their intrinsic worth.

There is little doubt that they will reduce ulcer pain. However, as far as healing is concerned, evidence indicates that very large doses are required. According to a leading Sydney gastro-enterologist who has treated ulcers for many years, “when given in high dosage (equivalent to 30 ml double strength aluminium hydroxide gel one hour before and after each meal and also before retiring), antacids have also been shown to be effective in treating peptic ulcers. Liquid antacids are generally more effective than tablet formulations, but are less convenient for the working person.”

Q. Could taking all that medication each day in itself produce unpleasant side effects?

A. It seems this is possible and many patients on high doses may develop diarrhoea or constipation. Also, long term, a condition called ‘hypophosphataemia’ with anorexia (loss of appetite), muscular weakness, and a bone condition called osteomalacia may take place, if used in high doses over prolonged periods of time. Other side effects are also possible, depending on the type of antacid used. One case was recently reported in the medical journals of a patient with very large bladder stones which had developed after many years of taking a calcium antacid.

However, there is little doubt that used with discretion, and under proper supervision, antacids can bring a good deal of symptom relief. They are cheap, readily available and, in smaller doses, may do little harm, even if they are not as dramatically beneficial as some of the newer forms of medication. The antacids are available in many forms, as mixtures, tablets, powders. Many patients will continue using them, especially if there is occasional abdominal discomfort. What’s more, they often help in simple cases of dyspepsia, a feeling of fullness, bloat, and the unpleasant sensation which commonly follows from ‘dietetic indiscretions’, as the doctors succinctly put it.

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While you should always first seek advice from your doctor if you’re troubled by back symptoms, there are also many instances in which other therapies can be very helpful. In fact, your doctor may well refer you to a physiotherapist or, at times, suggest that you consult a practitioner of an alternative therapy as many of these have a proven track record in dealing very successfully with back problems.

The so-called ‘other’ treatments are normally divided into two main groups:

The ‘complementary’ therapies that work alongside of and often as virtually part of conventional medicine; and

The ‘alternative’ therapies which, as the label implies, offer an alternative to conventional medicine.

Although the distinction between the two types of therapies is usually quite clear, it can become somewhat blurred when looking solely at how effective some of these ‘other’ therapies can be in dealing with back problems. For example, the relatively little known Alexander Technique is usually considered to be an alternative therapy. However, because it concentrates upon posture, something that is so directly and obviously relevant to back troubles, this method is perhaps more ‘complementary’ than ‘alternative’ when it comes to difficulties involving the spine.

Rather than try to classify therapies as either complementary or alternative, it seemed more logical in this book to separate them into two groups depending upon how commonly they are employed in treating back problems.

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